This Is How Fertility Impacts Sex

This is how infertility impacts sex, according to a new US study. Couples doing fertility treatment report high sexual distress levels, age has a bearing, and men react differently to women.

Cue an eye-roll when I discuss sex with my clients. A rueful laugh.What do you expect? It’s a long way from champagne-fuelled honeymoon bliss.

The most extreme, challenging form of sex in captivity has got to be baby-making sex. Things change when you’re trying to conceive after a few months. The initial ‘eat-all-you-want buffet’ loses its appeal after third or fourth helpings. “We weren’t surprised to find sexual distress in couples who are infertile,’ revealed study author Dr T.S. Rowen, from the University of California in San Francisco. Quick caveat here. It’s not all doom and gloom. Recovery is quick. It’s a major part of my work – helping couples navigate what is arguably one of the hardest things they’ll ever face. Stress, anxiety and depression tarnish happiness and challenge relationships. Mind you, infertility can, and does, forge some of the strongest bonds. Not everyone is so lucky. The study finds younger women are worst hit. Why is this?

Women take on the burden of infertility. There’s so much emotion tied into women’s reproductive goals. Sex becomes a means to an end, stripped of fun, passion and eroticism. Sexual confidence, body image, libido and the well-being of a flourishing sex life get lost.

The study of 324 couples finds women who believe their own infertility to be the only cause, have the highest sexual impact scores. Simply a 0-90 SUDS- type score, so higher scores indicate greatest distress.

These average 38 for women and 25 for men. For women in couples with male-only infertility factors the impact is lowest.

Researchers worked with participants in the 20-45 age bracket from private and academic fertility centres. 40% were married at least 5 years. They had previous oral fertility medication, injectable drugs or IUI before joining the study.

Women who perceive their fertility issues as due only to male factors show the lowest sexual impact, while those who believe their own infertility was the only cause, score highest.

I notice even when infertility diagnoses are shared between a couple, or it’s unexplained infertility, women often ‘take the blame’.

“Women tended to attribute it to themselves more than it was overall attributable when it’s both male and female factor,’ continues Rowan.

Younger women, below age 40, showed higher impact scores than older participants.
“I think it would be really interesting to do a study of how often doctors talk to patients about sex lives,” said Dr. Rowen. Ha! Doctors may ask, but patients tell me their replies are often ambiguous, embarrassed and overly optimistic! Fear of judgement, fear of impacting treatment and a clinical focus are most often cited as reasons for withholding deeply personal information – along with that plain old embarrassment. Paradoxically, even the closest couples find it easiest to discuss their sex distress with me individually. Lack of desire, erectile dysfunction, and general hostility feature largely. I often see only one partner and change is quick.

I find men are less likely to categorise their whole relationship as unsatisfactory when sex is poor, whereas women are inclined to globalise difficulties right across the board, exacerbating stress and fuelling resentment.

Studies like this spark discussion and reduce feelings of isolation. Let’s open people up to getting proper help for real distress, right from the start. It’s a mental health and wellness issue which goes far beyond fertility.

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